Ma. Lourdes C. Gonzales, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

243713 Issued in NY

Practice address

17541 Hillside Ave
Jamaica, NY 11432-5724

Phone

(516) 472-1710

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1985

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ma.Lourdes Castillo Gonzales,MD,PC

  • Specialist
  • Jamaica, NY
  • NPI 1114263332
  Medicare reassignment Authorized official
• Reverb Physical Therapy PC

  • Physical Therapist
  • Jamaica, NY
  • NPI 1073717542
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1770797680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 VILLAGE AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034236",
            "telephone_number": "516-472-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17541 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325724",
            "telephone_number": "516-472-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MA. LOURDES",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "243713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "243713",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vadim Goldshteyn, M.D.
• Natalia Gomez
• Nestor E Gomez
• Renee Marlene Gomez, LMSW
• Evangeline Mercado Gonzal, DPT
• Trisha Gonzales, PT
• Diane L Gonzalez, MSW
• Edith Jannette Gonzalez
• Emily Gonzalez
• Martha Gonzalez, R.N.

• Psychiatry Physician in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.